Subcutaneous immunotherapy (allergy shots) is the process that changes the immune system to ignore the allergen, which is triggering allergic reaction. It is also called desensitization. It is used to treat patients with respiratory allergies (such as hay fever, allergic rhinitis and asthma); stinging insect allergy and occasionally skin allergies i.e. atopic eczema.
Leonard Noon and John Freeman first described it in 1911. They injected hay fever patients with pollen to which they were allergic. Over the years, controlled studies in England and USA, established that this therepy is effective. Improvements have been made over the time in the quality of allergy extracts. Many allergen extracts available in the United States are standardized now.
Allergy shots not only control symptoms, but also decrease medication use while on allergy shots; It can lead to long lasting remission. Which means that patient continues to experience relatively symptom free period for years after patient discontinues allergy shots.
Patient who suffered anaphylactic shock after bees, wasps, hornets and yellow jackets, may live fear free life on allergy shots. The risk of anaphylaxis and severity of symptoms when patient is stung while on venom immunotherapy is very low.
Allergen avoidance is a good strategy when possible. But it is not always easy or practical. Allergy medications can bring relief in many, but can produce side effect as well as symptoms come backas soon as you stop the treatment.
Allergy shots need significant time and commitment especially build up phase. Patient also need to wait for 30 minutes after shots in a doctor’s office. There are cost considerations depending on your insurance coverage. Yet, it is cost effective treatment to manage your symptoms. Generally subcutaneous immunotherapy is used in the following situations:
Once the allergist has decided what is causing your allergic reaction, he/she formulates allergy extract, popularly known as allergy serum.The idea is to build immunity to one or more allergens. Patient starts with injecting a small amount but increases the dose once or twice a week, until patient reaches the top dose or target dose. Process of administering the increasing dose is called build up phase. It takes on an average of 4-8 months to reach that dose. Once you reach the target dose, you get the same dose at 2-4 week interval for 3-5 years. This is called maintenance phase.
There are risks involved with allergy shots but they are rare. Most important is the possibility of urticaria, asthma and anaphylaxis. These reactions can be treated but require immediate attention of a medical provider like M.D. or D.O.; nurse practitioner or physician assistant. Allergy shots need to be given in a facility equipped with staff and personnel.
Allergy shots are safe during pregnancy if patient has already reached the maintenance dose. Allergy shots should not be started if patient is pregnant.
Patient should not get allergy shot if they are on beta blockers. If patient were to get reaction after the allergy shot, they may not respond well to medicine to reverse the reaction.